Most Relevant Information
Provider Data
| NPI Number: | 1003336801 |
| Provider Name: | JENNIFER LEACE MS CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SA16375 |
Most Important Dates
| Enumeration Date: | 06/22/2017 |
| Last Updated: | 06/05/2020 |
Provider Practice Location
1790 SW 43RD WAY
FORT LAUDERDALE
FL
333175701
Practice Location Phone/Fax
| Phone: | 9545848000 |
| Fax: |
Provider Mailing Location
10139 AKENSIDE DR
BOCA RATON
FL
334283004
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |